What Magic Mouthwash Is and How It Works

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Magic mouthwash is a mouth rinse often prescribed for people with mouth sores (oral mucositis) caused by chemotherapy, radiation therapy, and some targeted therapies. It is also used for oral thrush and oral pain caused by certain infections. The mouthwash comes in a variety of formulations, under different names, and can be used by both adults and children.

This article will discuss how magic mouthwash is used and its ingredients. It also covers how well it works, potential side effects, and more.

Person pouring medication into a dosage cup
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What Is Magic Mouthwash Used For?

Mouth sores typical of oral mucositis are characterized by red patches, swelling, or ulcers in the mouth. Magic mouthwash is used to diminish the pain from these symptoms, which can commonly develop due to chemotherapy and radiation treatments.

In some cases, chemotherapy-induced mouth sores can be so painful that they cause problems with eating, swallowing, and talking. Sometimes secondary bacterial or fungal infections can develop.

Weight loss, which is concerning in people with cancer, can occur when mouth sores make it painful to eat. Cancer cachexia, a syndrome that involves decreased appetite, weight loss, and muscle loss, is thought to be the direct cause of death for 20% of people with cancer. Since cachexia isn't easily treatable, preventing weight loss by managing any problem that interferes with eating is crucial.

Other Names for Magic Mouthwash

  • Miracle mouthwash
  • Mary's magic mouthwash
  • Duke's mouthwash

Magic Mouthwash Ingredients

There is no standard recipe for magic mouthwash. Most formulations include some combination of the following ingredients:

  • Antihistamine/anticholinergics: Antihistamines such as Benadryl can reduce swelling.
  • Antacids: Several different antacids, such as magnesium hydroxide/aluminum hydroxide, may be added to coat the mouth and throat.
  • Anesthetics: Anesthetics such as viscous lidocaine work to numb the mouth and reduce pain.
  • Antifungals: Antifungals such as nystatin may be added to reduce the chance of a secondary fungal infection (thrush).
  • Antibiotics: Some preparations, such as tetracycline, contain antibiotics added to reduce the chance of secondary bacterial infection.
  • Corticosteroids: Steroids can reduce inflammation, resulting in less redness and swelling.

How to Use Magic Mouthwash

Here are the steps to follow for using magic mouthwash properly:

  1. Pour your prescribed dose of the mouthwash into a sterile spoon or measuring cup.
  2. Keep the liquid in your mouth and swish it around for a minute or two.
  3. Spit out the mouthwash since swallowing it can cause side effects, such as an upset stomach.
  4. Avoid eating or drinking anything for at least 30 minutes after using magic mouthwash.

Since there are so many different formulations, it's important to ask your pharmacist how to use the one prescribed to you.

To find out how long it lasts after it's opened, check with your pharmacist and read the label regarding the formula you're using.

Can You Make Your Own Magic Mouthwash?

There are DIY mouth rinses that you can put together with common kitchen ingredients, but these differ from most medical formulations of magic mouthwash. Magic mouthwash usually contains at least one (and often more) ingredient that requires a pharmacist to prepare and requires a doctor's prescription to obtain.

Dosage and Frequency

For most preparations, instructions are to use 2 teaspoons of the solution to swish and spit out.

The process is repeated after meals and at bedtime. Wait about 30 minutes after using magic mouthwash before eating or drinking. The effects of magic mouthwash typically last about four hours.

Cost

The price of an 8-ounce bottle of magic mouthwash ranges from $35 to $65. It may or may not be covered by your insurance plan, so call your insurance provider.

Magic mouthwash requires a doctor's prescription to be prepared by a pharmacy.

Risks of Magic Mouthwash

The risks of magic mouthwash depend on the ingredients in the formula.

Formulations that contain a local anesthetic could potentially mask symptoms that would normally alert you to call your healthcare provider. This numbing effect could also make it more likely that you'll bite down on the inside of your mouth or even choke when eating.

There are also potential risks associated with medications such as antihistamines, antibiotics, and antacids.

What Happens If You Swallow Magic Mouthwash?

It is not dangerous if you swallow magic mouthwash by accident, but it's better to spit it out. Swallowing it can cause an upset stomach.

Side Effects

Side effects can vary depending on the formulation and may include:

  • Mouth numbness
  • Taste changes
  • Irritation
  • Pain

Some of the side effects can be difficult to distinguish from an allergic reaction, and it is hard to tell which ingredient is causing the reaction.

If you experience side effects, stop using magic mouthwash and contact your healthcare provider.

Is Magic Mouthwash Effective?

The benefit of magic mouthwash has come into question. The variations in formulas make it difficult to study. Some health experts recommend against using it, saying there's not enough evidence that it's more effective than salt water or baking soda rinses.

A 2019 study compared the results of magic mouthwash and doxepin mouthwash for radiotherapy and chemoradiotherapy patients. They found a limited improvement in pain for both mouthwashes, but not enough to be considered clinically important.

However, anecdotal reports from physicians and patients attest to at least some benefit in reducing pain with some formulations, so magic mouthwash is frequently prescribed.

Ask your treating cancer physician (oncologist) for their input about magic mouthwash. Mouth sores are common in people with cancer, so oncologists have insight into what may help reduce the pain. Your oncologist can offer guidance based on what has worked for other patients.

Other Treatments for Mouth Sores

For mild mouth sores, homemade mouthwashes, such as baking soda mixtures, may reduce the risk of developing a secondary infection.

Other helpful treatments include:

  • Morphine mouthwash: Some research has found that topical morphine mouthwashes work better than magic mouthwash for treating mouth sores in cancer patients.
  • Cryotherapy: Several studies have found cryotherapy (ice) to be beneficial, especially for more severe mouth sores.
  • Palifermin: Palifermin is a synthetic version of keratinocyte growth factor (KGF), a molecule that promotes the healing of mouth sores. Palifermin is currently approved for treating mouth sores in patients with blood cancers.
  • Low-level laser therapy: Low-level laser therapy has been shown to reduce pain from oral mucositis and work more quickly in some cases than other methods.

Summary

Magic mouthwash is often prescribed to help treat pain caused by mouth sores. These sores may develop from chemotherapy and radiation. Magic mouthwash's ingredients may vary but often include a combination of antihistamines, antacids, anesthetics, antifungals, antibiotics, and corticosteroids.

Some research has questioned the effectiveness of magic mouthwash in treating the pain of mouth sores. Talk to your healthcare provider about whether you should use magic mouthwash or an alternative like cryotherapy or morphine mouthwash.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Blyss Splane
Blyss Splane is a certified operating room nurse working as a freelance content writer and former travel nurse. She works as a freelance content writer for healthcare blogs when she's not spending time with her husband and dog.

Originally written by Lisa Fayed